Manchester Youth Alliance, LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

MANCHESTER YOUTH ALLIANCE, LLC

Practice address

1056 River Rd
Manchester, NH 03104-1958

Phone

(603) 353-9102

Fax

(603) 353-9412

NPI assigned

May 5, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeff Park

Title

Manager

Phone

(603) 254-2808

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1386265023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "ORFORD",
            "state": "NH",
            "postal_code": "037770325",
            "telephone_number": "603-353-9102",
            "fax_number": "603-353-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 RIVER RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031041958",
            "telephone_number": "603-353-9102",
            "fax_number": "603-353-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER YOUTH ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "603-254-2808"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manchester Vamc
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• Manchester Walk in Dental Clinic PC (NH Walk In Dental Clinic)
• Niamh M Mancini
• Robert Mancini, CRNA
• Michele D Mandel, M.D.
• Allison Mangels, PT
• Milana Mangic, BA

• Emotionally Disturbed Childrens' Residential Treatment Facility in Manchester, NH
• Providers in Manchester, NH by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.